A new clinical test for breast cancer that offers clinicians more detailed information about cancer type and likely behavior could be available to patients within two years.
The test, called the Nottingham Prognostic Index Plus (NPI+), will help clinicians create more personalized treatment plans for patients. Details about the test are reported in the British Journal of Cancer.
The current Nottingham Prognostic Index (NPI) was developed more than 30 years ago and is used worldwide by clinicians to determine the risk of breast cancer returning.
However, breast cancer is now known to be a biologically complex disease and its various forms can have very different outcomes. The more information doctors have about each patient’s cancer, the better they can plan effective treatments.
10 biomarkers and beyond
The new NPI+ test has been developed from the existing NPI by incorporating the measurement of 10 proteins (biomarkers) found in breast cancer cells. These biomarkers include ER and HER2, the two biomarkers currently tested for in clinics, but also others that are not currently tested.
The new report is a follow-up to research published in the British Journal of Cancer in October 2013 in which the team described seven classes of breast cancer using those ten biomarkers. Researchers took these seven classes of breast cancer and incorporated other factors to develop the NPI+, which can be used in all breast cancer patients to give a more accurate prognosis than is currently available.
“Using a panel of 10 biomarkers and other clinical information, we are able to categorize women with breast cancer into one of seven treatment-specific classes based on their personal cancer biology,” says Ian Ellis, a professor at the University of Nottingham, who led the study. “We believe the categorization of women with breast cancer into more specific risk classes will deliver better targeting of relevant therapies, which will result in improved outcomes with reduced costs and less anxiety for the patient.
“NPI+ will reduce uncertainty for clinicians and patients by removing a large number of patients with indeterminate prognosis and allow better-informed treatment decisions. In addition the ability to give survival prediction will be welcomed by concerned patients. Decisions can be made more quickly reducing waiting times and unnecessary consultation time.”
The NPI+ test was developed using more than 1,000 breast cancer samples and was shown to predict both patient survival and to identify patients most at risk of treatment failure—helping doctors to consider additional forms of treatment to improve survival.
The Medical Research Council funded the study.
Source: University of Nottingham